Apparatus for colonic therapy



May 2, 1950 A. TOUCHBERRY 2,506,183

APPARATUS FOR QOLONIC THERAPY Filed Sept. 30, 1947 s Sheets-Sheet 1 [I W" IIW'" W" W MN MW w M W INVEN 7012 fllia' Thai: kerrg ATTORNEY y 1950 A. TOUCHBERRY 2,506,183

APPARATUS FOR COLONIC THERAPY Filed Sept. so, 1947 3 Sheets-Sheet 2 a F- N g of Q Q HTTO RNEY May 2, 1950 A. TQUCHBERRY 2,506,183

APPARATUS FOR COLONIC THERAPY Filed Sept. 30, 1947 3 Sheets-Sheet 3 w A sm k INVENTOR HTTORNEY Patented May 2, 1950 UNITED STATES PATENT OFFICE APPARATUS FOR COLONIC THERAPY Alice Touchberry, Palm Beach, Fla..

Application September 30, 1947, Serial No. 777,084

9 Claims.

This invention relates to apparatus for colonic therapy, and more particularly to tables and cooperating appurtenances for intestinal and like treatments such as involve the introduction of liquids for cleansing, irrigation, medication or other purposes. While deep and vigorous injection of liquid has often been thought to constitute a chief criterion of therapeutic methods of this type, the present invention is designed to provide novel means for eifectuating colonic treatments in accordance with special principles that have now been found of peculiar importance. For instance, the comfort of the patient, the facility with which the operator may handle the equipment and observe results, and especially the position of the patients 'body with respect to gravity or physiological forces acting on the liquids and wastes, are factors of prime significance, in an inter-related manner. A more comfortably supported patient is in a more relaxed condition, allowing better penetration of the injected liquid with less pressure, and permitting fuller realization of any desired muscular or other physiological reaction of the organs under treatment. At the same time, by positioning the patient so that full advantage may be taken of gravity to assist the inward or other flow of liquid, very low pressures may be employed and deep insertion of instruments avoided; in consequence the patients comfort is again enhanced,

with further resulting benefit in the efiectiveness of the treatment, as explained above. Improvemerit in these respects also makes administration of the process easier for the operator, and to the extent that the several parts of the apparatus can be more readily controlled or adjusted, and the character of' results more directly detected, the attainment of a desired therapeutic benefit without discomfort to the patient passes from the realm of guesswork to that of scientific certainty.

A chief object of the invention, therefore, is to provide improved apparatus having the characteristics described above for promoting the efficacy and convenience 'of such treatments, a further object being to provide equipment of the stated kind, which affords a maximum of comfort to the patient and which permits a definite avoidance of pain and physiological harm.

Another primary object is to provide a novel table for treatments of the character described, including means for supporting the various parts of the patients body in an eminently comfortable manner which at the same time promotes the ministration. Other objects are: to provide apparatus of the stated nature, including improved supporting arrangements of an adjustable character and having proportions and dimensions found peculiarly effective for the desired results; to provide such apparatus having novel means for receiving and removing waste, i. e. discharged material, the waste-receiving means cooperating structurally and functionally with the supporting and other elements of the table and also affording ready inspection of the discharged material; and to provide an arrangement of the stated instrumentalities, together with liquid supply means, which is adapted for convenient manipulation or adjustment by the operator.

A further and particularly important object of the invention is the provision of a colonic therapy table comprising improved waste-receiving and supporting structure (preferably having adjustable portions) wherein the supporting arrangement includes means to provide a massaging mction' appropriate to the treatment that is being administered.

To these and other ends, including such as will become apparent from the following description or may otherwise be inherent in the improved apparatus, certain advantageous embodiments of the invention are shown in the drawings and described hereinbelow, by way of example to illustrate the several features, combinations and principles of improvement.

Referring to the drawings:

Fig. l is a side elevation of one form of the improved table for colonic therapy, a portion of the side enclosure being broken away to reveal certain mechanical parts;

Fig. 2 is a plan view of the table of Fig. 1;

Fig. 3 is an end elevation of the table as viewed from the left-hand side of Fig. 1, a portion of the table enclosure being broken away;

Fig. 4 is a fragmentary perspective view showing a portion of the table embodying a combined supporting and massaging arrangement in accordance with the invention;

Fig. 5 is an enlarged, fragmentary elevation of the structure of Fig. 4, partly in central, vertical section;

Fig. 6 is a section on line 6-6 of Fig. 5;

Fig. 7 is a section on line ll' of Fig. 5, b'ut showing the movable structure rocked away from a central position; and

Fig. 8 is a fragmentary perspective View of certain parts shown in Fig. l, with alternative connections for a different type of motion. qTh'e illustrated embodiment of thev apparatus,

as shown for example in Figs. 1 to 3, comprises a table generally designated H), which may be built as a cabinet, if desired, and which has a top I I including a central supporting structure I2. A plane support element M is hinged for vertical adjustment on one side of the central section l2, and another support element I5 is similarly hinged to swing vertically on the other side of the portion 12. The table also has a further, stationary supporting surface it beyond the rising part [5, the complete arrangement being designed to receive a patient in reclining position, with his back and head resting on the portion 14, the upper; part of; his legs on the support l5, and his knees disposed over or beyond the outer edge of the latter sothat his feet rest on the surface !6,; e; g. against a weighted foot rest 48. .It will be understood that the table or parts of it may be manufactured of wood, metal or other suitable material;

for; instance the structure shown is made chiefly of wood; and includes an appropriate bracing and supporting framework l9; the sides being conveniently closed by panels with suitable doors for access to the working parts hereinbelow described.

Thesections I 2; Hand [5 for supporting, the patient are preferably cushioned. For example. the central member [2 and theleg rest l5: may carry a pad 21 of sponge rubber or the like, say one: inch: thick; removabl'y seated so that it can be taken off for cleaning the apparatus. A removable pad' 22. is also provided for; the back support It, and is advantageously of an upholstered or mattress-like character for a relatively deep-cushioning. effect. Supplemental pads. may likewise be employed, such; as a. pillow 24 for the patienfls head and" a small, highly elastic cushion 25"which can be-placed, for instance, over the junction'of the pads 2 I and'22 to support the small of the patients back.

A waste-receiving vessel comprising a bowl 28 opens through the top of the table at a central region, e. g. partly through the support portion I2 andpartly through the leg rest I5; bothof the latter parts have curved openings to conform with the corresponding regions of the mouthof the bowl, as shown in Figs. 1 and 2, and the pad 2| has a similaraperture. A curved guard or shield 30 carried by the adjustable support member !5, depending from the opening in the latter, 1. e. from all parts of the edge of the opening, and the shield 30 is shaped to telescopewithin the bowl 28' sothat when the support !5 is raised, e. g. to any upper position such as indicated by dot-and dash lines, the shield forms anextension of the wall of the waste-receiving vessel, thus insuring that material eliminated or discharged by the patient, or any other released flow of liquid, will be caught by the bowl. Hence the patientmay be supported in a particularly advantageous manner, both for comfort and for therapeutic purposes of the treatment, and at the same time the mechanical removal of discharged material or surplus liquid is always efficiently-and completely achieved. The outlet from the bowl 28 extends through a trap-3|; which may comprise a curved pipesection of considerablelength, made of-glass orother transparent-substance to permit visual examination of the discharged materials, as with the aid of an electric lamp 32 behind the trap. The outlet from the trap extends to a suitable drain conduit, either directly or through a further trap SS-having a plug 34 which is removable so that samples of the effluent can be withdrawn for analysis or other examination.

Hot, warm or cold water or other liquids or solutions used in the treatments may be derived from any suitable source; by way of example, the illustrated apparatus includes an upright cabinet section 35 mounted at the foot of the table, and containing tanks (not shown) from which liquids may be dispensed as needed, it being understood that the cabinet 35 may also enclose suitable heating or other temperature-controlling means (not shown) for the liquids. The amount of contents and the temperatureiconditiom of the tanks may be indicated by suitable gauges 35, and the supply of solutions, water" or other liquids to the tanks and especially to; the table from the tanks or from the supply mains 31 (both for treatment purposes and for flushing the bowl 28), can be controlled by suitable valves 38-it being desirable: to regulate carefully" the pressure and rate of flow of; the. liquid, injected for treatment.

correspondingly necessary pipes connect. the cabinet, section 35: with the; table propen For example. a; pipe lllqextends to. a: suitable fitting 4'! at; an upper part: of thebowl sov that a spray or stream ofwater may be projected into and around; the bowl to flush it; if desired the fit,- ting may be mounted on the guard. 30,. the pipe 40 then including a flexible portion to permltthe necessary changes of. position. Tofeed the: var.- ions" solutions or other liquids for the.- colonic treatment; a pipe 42 also extends from the supply and, regulator cabinet, and continues through afl'exi-ble tube 4-3 toa check: valve 44- w-hich is mounted atacentrahouter locality of the support 55 andwhichhas an outletnipple 45. A flexible connecting tube 46 is fitted over; the nipple-and terminates in a suitable, thin, rectal injection tube 48 designed to be inserted: in the rectum of the patient, butpreferably only'to a distance of several inches or less. Thus the-edesired liquid can beinjected continuously into the colon of the patient, outflow from the latter taking place either simultaneously around the tube or upon its removal, depending; on the condition or stage of treatment. The check valvetse-rves an important sanitary f unction in preventing any back flow'of liquid; into the conduit -42, i. e. into a locality-- that cannot be, easily cleaned; and sterilized.

Means are provided for. raising and lowering the, otherwise freely swinging, table sections l4 and I5, and while other, powered instrumentalities may beused, suchas; electricallyactuated lifts, the; apparatus shown embodies, by way-of example, a. pair of hydraulic jacks 50, 5| respectively controlled for lifting operation: by-pedals 52, 53, and assistedintheir returniondownward movement (uponv interruption, ofthe. suppliedhydraulic pressure, by means not shown) bysets of coil springs 54, 5.5. The plunger 51 of the jack 5|. is pivotally connected (with necessary lateral freedom of .motion) to acrank arm 585onaashaft 60 which carriesapair. of. arms. 6i linkedbypush rods 62: to the underside ofi the support member l5. Thus when the jack plunger 51 rises, the arms areswung clockwise (in Fig. I) and the member I 5 tilts upward, coming-to rest whenever the: attendant releases his: pressure on the pedal 53. Likewise the plunger 64 of the Jack 50 is linked by the U-shaped actuatingrod 66 to the underside of'thesupport section M, for: similarly controlled, vertical displacement: of" the latter about :its horizontal axisoztiswing.

In accordance with a further feature of the invention, means (not shown in Figs. 1 to 3) are preferably provided for automatically applying a massaging motion to the patient, specifically means structurally and functionally combined with the central supporting structure I2. To that end, at least a substantial part of the latter is movably mounted, and driving means are included for reciprocating the movable section, e. g. instrumentalities selectively adapted to rock it crosswise of the table or simply to vibrate it. While any of a variety of mechanical arrangements may be employed to fulfill this part of the invention, one suitable construction is shown, simply by way of example, in Figs. 4 to 8 inclusive, wherein all parts not shown may be identical with corresponding elements of Figs. 1-3. Referring first to Figs. 4 to '7, substantially all of the central table section I2, except for a strip I9 sufficient to mount the hinges or pivots for the leg support I5 and to surround the forward portion II of the bowl 29, is constituted by a platform I2 having an opening or recess I3 which clears the bowl 28 sufficiently (i. e. at the sides) to permit the desired motion of the platform. The platform I2 is secured on a multiplicity of strong coil springs I5 which are mounted on a carriage I5. The carriage is fitted with four wheels I8, adapted to roll on two pairs of curved track sections or rails I9 so that it may be rocked, within a limited distance, about an axis lying well above the top of the table.

A pair of arms 89 are secured to the ends of the platform I2 and extend down from the latter through guide and retainer plates 8! on the ends ity of the arms 89, the structural continuity of the table being provided by reinforcing beams 84 (Figs. 5, 6 and '7) extending past either side of a housing 85 around the bowl 28. Removably secured to the bar 82 on three pins 81, a bifurcated plate 88 depends from the bar, providing a long vertical cam slot '89 to be traversed by a roller 99. The roller 99 is rotatably carried on a pin 9| which may be removably seated in any one of a series of holes 92 in the face of a disk 93 mounted on a shaft 94. The shaft is journaled in a suitable bearing 95 and is driven through gearing 96 by a variable-speed motor and transmission unit 98 of suitable character.

Thus as the motor drives the disk 93, the eccentric roller 99 in the slot 89 moves the plate 88 from side to side, and the carriage I9 and platform I2 are similarly reci'procated with a rocking motion, by reason of the curved shape of the rails I9 (of. Figs. 6 and 7). The length of stroke may be adjusted, to suit the requirements of this type of massaging motion to the particular purposes of a given treatment, by changing the pin 9| to a hole of different eccentricity relative to the shaft 94, and the speed or frequency of reciprocation may likewise be varied by adjusting the speed of the motor drive 98.

If it is desired to vibrate the central supportof the table, i. e. the platform I2, in a vertical direction alone, the plate 88 is replaced by a link I99, pivoted on one of the pins 8! and on the roller 99, as shown in Fig. 8. To prevent transverse motion of the carriage, retaining bars I92 on either side of the table are slid through guide plates I93, I94 so that they obstruct any lateral motion of the arms 89; and each bar I92 may 6. have an upper hook-like projection I95 which is adapted, when the bar is moved to restraining position, to engage the upper surface of a pin I96 on the carriage I6, so that the latter cannot move vertically. Thus assuming that the link I99, of suitable length, is initially fitted to the pin 81 and roller 99 when the latter is associated with a selected hole 92 (usually the innermost one, of least eccentricity) and conveniently when the disk 93 is disposed with such hole in its lowermost position, operation of the driving motor will reciprocate the link in the manner of a connecting rod. The platform I2 will be correspondingly vibrated, against the springs I5 and in a vertical direction; the arms 89 are adapted to slide only in such direction under the retaining plates 8| and retaining bars I92, and the carriage I9 is positively held against any displacement. The arrangement shown in Fig. 8 thus provides analternative type of massage, e. g. a simple vibration, which is of value in at least some kinds of treatment for which the table may be used.

The pad on the sections I 2 and I5 may be made in two corresponding portions in the structure of Figs. 4 to 8, so that the pad portion I91 on the platform I2 is separate and free to move with the latter; if desired it may conform much more closely to the bowl opening than does the platform, and may have a skirt I98 of flexible, waterproof material depending in the opening. That is to say, the pad portion I9! is separate from the remaining pad portion I9Ia (Fig. 4) which covers both the section I5 and the straight part of the section 19, the pad portions together corresponding to the pad 2i of Figs. 1 and 3. The pad ID! has an opening which conforms with that of the bowl 23, the pad I9! conveniently overlapping the upper edge surface I9 of the bowl housing such upper edge surface, as described above, may be considered as that part of the stationary portion I9 of the center section (generally designated I2) which goes around the bowl. As shown in Fig. 7, when the platform I2 is rocked one way, the under side of the pad I91 at one side of the bowl may be engaged by a corner of the edge I9, compressing the pad at this locality, while on the other side of the bowl the pad may be stretched between the skirt I98 and a locality where the pad frictionally grips the platform surface, the compression and stretching of the pad I9I being reversed when the platform I2 is rocked the other way. I

Referring again to Figs. 1-3, further and particularly important features of the invention reside in certain structural and dimensional rela tionships among the supporting sections of the table. In the first place, it is extremely advantageous for the section I4 to be so located relative to the supports I2 and I5 that the upper part of the patients body, i. e. the upper part'of his back, can rest at a level lower than his hips (or any other part supported by the sections I2 and I5), even when the support I4 is tilted substantially upward. Under such circumstances, with the illustrated table, the patient is comfortably supported and may even believe that his back is at a higher level, but the actually lower disposition of his back is of great importance i'to the colonic treatment, especially in effectuatiri'g (with the aid of gravity) a deep but gentle pene traticn of liquid such as cannot be conveniently or comfortably obtained by means of high pressure injections through deeply inserted instru ments. In defining the levels of the several table sections'herein, it will be understood that-each 1 mustbeconsidered as includingits padding, cushion 1 or; the like-the 1 effective supporting surface being; that of: the padding OI? cushion, lowered somewhat-by the: natural depression of. the patientisiweight- Asstated. thehinging, of the member M at a levelilowerrby several-inches.(say, 3 or 4 inches) than-the; member l2, andthe selection of a suitable thickness for the cushion 22, permit the desired difference in: levels of support (especially considering. the cushion. 22 more or less. depressed as; shown. at Ill)v in Fig. l) whenthe member N2 horizontal or, is: tilted at any angle up to about: 15, to the horizontal. At. greater angles, therdiiference. in levels is, reversed;v such condition beingzdesirable. (i. e. for ejection of fluid) at some stages or; certain. treatments. Inv some cases, the construction. may be such aszto provideior even greater: tilt without raising the patients shoulders; above; hisv hips, but; generally, provision shonldlbe' made to reach such condition at least at anangleofabout 30 (or preferably less as in theapparatus shown) For optimum support of the patient, the dimensions, lengthwise of the table, of the sections Hand [5. are of'great importance, and may be considered. to be of a critical nature if the table istdbe used withequal satisfaction for treating patients: of. widely different sizes, proportions, ages. and weights. More specifically, ina greatly preferredtdesigniof table-adaptable to extremely widevariationamong patients, the dimension i l2 of? the central structure should be about six to seven inches, and. the dimension H5 about 15 inches. In. one suchtable, the bowl opening is about 14 inches long, overlapping the portion i2 (sog-turspeak) by about 4 inches. At least for good. results; with considerable difference; among patients, the; central dimension H2 may be 4: to 8:=inches-,..and the dimension H5 may be 12 to 18 inches; Substantial departures from these dimensions are apt to cause discomfort to some patients; or impair their full realization of the benefits of treatment. Conveniently the foot portion. Hi of the table has a level lower than the top-of. the cushion 2! by two or three inches.

It will now beseen that the described apparatus is of definite advantage in promoting the; patients comfortand in efiectuating the desired.- therapeutic treatment. 11118, comfortable reclining position at all times, yet the position is one whichis peculiarly suited to, the treatment; he need not sit up, turn over or movein'any other way at any stage. He can, however, be changedin position by the operators controL, while the several injection and wastecollecting means. always remain in optimum location; for their intendediunction. Likewise, without even moving the patient at all, massage of various kinds can be automatically administered, in; a dorsal region, which is to be preferred for such: purpose. The entire apparatus is easy to use; and control, so that work of the operator is tremendously facilitated; and cleaning and sterilization of various exposed parts is readily achievedatdesired times.

This application is a. continuation in part of my copending application Serial No. 746,357, filed May 6.,11947, f1or Operating table, The; invention of. a colonic therapy apparatus havin a transparent'trapstructure for. observation of discharge material, which is disclosed herein, is being claimed in. my aforesaid co-pending application, Serial No..74=6,-357, filedMay 6, 1947;

it, is. torbe. understoodthat the inventionis. not

The patient rests 8, limited to the specific structures herein. disclosed, but may be.v embodied in other. forms without departurefrom its-spirit as defined by the following' claims.

I claim:

1. In, apparatus for colonic therapy, in combination, a central supporting structure, a support for the upper part of a patient hinged adjacent one side'of the central structure for vertical adjustment, a support for the upper part of the patients legs having a normally horizontalv position and hinged adjacent the other side of the central; structure to swing upward for vertical adjustment to elevate the said upper part of. the patients legs above the central supporting structure, and; a waste receiving vessel opening partly through said central structure and partly through said legsupport.

2. In apparatus for. colonic therapy, in combination, a table for supporting a patient in reclining position and a waste receiving vessel opening through said table at a central region thereof, said table including portions adapted to support respectively the upper part of the patient and the upper part of the patients legs, said portions being mounted toswing about horizontal axes spaced respectively from opposite ends of the table for adjustment of their positions of support, said table including a central supporting structure separating the said. swinging portions at the center region. of the. table, said central structure extending between said portions, said. portion which is adapted. to support the upper part of the patients. legs being pivoted adjacent the said central structure. and being adapted to swing upwardly to elevate said part of the patients legs to positions above the saidv central structure, and said vessel opening partly through said central structure 1 and. partly through said leg-supporting portion.

3. Inapparatus for. colonic therapy, in combination, av table for. supporting a patient in reclining position and a waste receiving vesselopening throughsaidtable at a central region thereof, said table. comprising a central supporting structure. and portions hinged for vertical adjustment upward from a horizontal position on opposite sides of. said supporting structure to receive respectively theupper. part. of. the patient. and the upper. part of the patients legs, and said. central structure comprising a movable element adapted to be disposed. beneath the patient and constituting part of the support for the. patient, said movable element having means for reciprocating said movable element to agitate the supported portionof the patient.

4. In apparatus for colonic therapy, in combination, a table for supporting a patient in reclining position and a waste receivin vessel opening through said table at a centralregion thereof, said table comprising a central supporting structure extending about four to eight inches lengthwise of. the table, a support for the upper part of the patient disposed on one side of said central structure and vertically adjustable, and a support for the upper part of the patients legs disposed on the other side of the central structure. and, hinged on av horizontal axis adjacent said structure to swing; upward for vertical; adjustment to positions above said central structure, saidleg support extending about twelve to eighteen inches lengthwise of the table, and said vessel opening partly through said central structure. and partly through said leg support.

5. In table apparatus for colonic therapy, in

combination, a central supporting structure extending about four to eight inches lengthwise of the table, a support for the upper part of a patient comprising a substantially plane, cushioned member hinged adjacent one side of the central structure for vertical adjustment, a support for the upper part of the patients legs hinged adjacent the other side of the central structure to Swing upward for vertical adjustment to positions above said central structure, said leg support extending about twelve to eighteen inches lengthwise of the table, and a waste receiving vessel opening partly through said central structure and partly through said leg support, said cushioned, hinged member being dis- 1 posed to have a horizontal position below the level of the central supporting structure and being hinged on an axis below the level of said central structure so that throughout a small range of angles of tilt up to about 15 above said hori- 5 6. In apparatus for colonic therapy, in com- I bination, a table for supporting a patient in reclining postion and a waste receiving vessel opening through said table at a central region thereof, said table comprising a central supporting structure and normally horizontal portions hinged to swing upward for vertical adjustment on opposite sides of said supporting structure to receive respectively the upper part of the patient and the upper part of the patients legs, and said central structure comprising a movable element adapted to be disposed beneath the patient and constituting part of the support for the patient, said movable element having means for rocking the said movable element substantially transversely of the table, to agitate the supported portion of the patient, said vessel opening partly through said central structure and partly through the portion for receiving the upper part of the patients legs.

7. In apparatus for colonic therapy, in combination, a central supporting structure, a sup- 1 port for the upper part of a patient hinged adjacent one side of the central structure for vertical adjustment, a support for the upper part of the patients legs hinged adjacent the other side of the central structure to swing upward for vertical adjustment to positions above said central structure, and a waste receiving vessel opening partly through said central structure and partly through said leg support, said central structure comprising a movable element adapted 5;.

to be disposed beneath the patient and constituting part of the support for the patient, said movable element having means for vibrating the said movable element to agitate the supported portion of the patient without substantially displacing said element in a direction transverse of the table.

8. In apparatus for colonic therapy, in combination, a central supporting structure, a support for the upper part ofa patient hinged adjacent one side of the central structure for vertical adjustment, a support for the upper part of the patients legs hinged adjacent the other side of the central structure to swing upward for vertical adjustment to positions above said central structure, and a waste receiving vessel opening partly through said central structure and partly through said leg support, said first mentioned hinged support being disposed to have a horizontal position below the level of the central supporting structure and being hinged on an axis below the level of said central structure so that throughout a small range of angles of tilt above said horizontal position but not beyond a predetermined angle which is less than 30 above the same, said first mentioned hinged support is adapted to hold the upper end of the patients torso at a level below the lower end thereof when said lower end is disposed on said central structure.

9. In apparatus for colonic therapy, in combination, a central supporting structure, a support for the upper part of a patient disposed on one side of the central structure, a support for the upper part of the patients legs hinged adjacent the other side of the central structure to swing upward for vertical adjustment to positions above said central structure, and a waste receiving vessel opening partly through said central structure and partly through said leg support, said leg support having a shield movable therewith and disposed in telescoping relation within the vessel to provide an extended wall for the vessel throughout a multiplicity of positions of said adjustment of said leg support, and said shield being open at the side thereof nearest the central structure so that the partial opening of the vessel through the central structure provides direct communication through the central structure into the vessel.

ALICE TOUCHBERRY.

REFERENCES CITED The following references are of record in the file of this patent:

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